H1N1流感常见问题

SWINE INFLUENZA FREQUENTLY ASKED QUESTIONS 关于甲型H1N1流感的常见问题
Note: Both the Chinese and English versions are from the official web of WHO 注：中英文皆来自世界卫生组织官方网站
What is swine influenza? 什么是甲型H1N1流感？
Swine influenza, or “swine flu”, is a highly contagious acute respiratory disease of pigs, caused by one of several swine influenza A viruses. Morbidity tends to be high and mortality low (1‐4%). The virus is spread among pigs by aerosols, direct and indirect contact, and asymptomatic carrier pigs. Outbreaks in pigs occur year round, with an increased incidence in the autumn and winter in temperate zones. Many countries routinely vaccinate swine populations against swine influenza.	甲型H1N1流感是猪的一种高度传染性急性呼吸道疾病，由一种或多种猪流感A型病毒引起。发病率往往较高，但死亡率较低（1-4%）。通过浮质、直接和间接接触以及携带病毒但无症状的猪，病毒在猪群中传播。全年都可发生猪群疫情。在温带的秋季和冬季，发病率上升。许多国家作为常规为猪群接种猪流感疫苗。
Swine influenza viruses are most commonly of the H1N1 subtype, but other subtypes are also circulating in pigs (e.g., H1N2, H3N1, H3N2). Pigs can also be infected with avian influenza viruses and human seasonal influenza viruses as well as swine influenza viruses. The H3N2 swine virus was thought to have been originally introduced into pigs by humans. Sometimes pigs can be infected with more than one virus type at a time, which can allow the genes from these viruses to mix. This can result in an influenza virus containing genes from a number of sources, called a "reassortant" virus. Although swine influenza viruses are normally species specific and only infect pigs, they do sometimes cross the species barrier to cause disease in humans.	最常见的猪流感病毒为H1N1亚型，但其它亚型也在猪群中传播（例如H1N2、H3N1、H3N2）。除猪流感病毒之外，猪还可感染禽流感病毒和人类季节性流感病毒。据认为，H3N2猪病毒最初是由人类传给猪的。有时猪可同时感染一种以上类型的病毒，从而可以使这些病毒的基因混合。这可产生含有来自若干来源基因的流感病毒，即“重组”病毒。虽然猪流感病毒通常具有物种特异性并仅感染猪，但有时也会跨越物种界线并在人体中引起疾病。
What are the implications for human health? 对人体健康有什么影响？
Outbreaks and sporadic human infection with swine influenza have been occasionally reported. Generally clinical symptoms are similar to seasonal influenza but reported clinical presentation ranges broadly from asymptomatic infection to severe pneumonia resulting in death.	偶尔报告过人感染甲型H1N1流感的疫情和零星病例。一般临床症状与季节性流感相似，但报告的临床表现范围很广，包括无症状的感染到造成死亡的严重肺炎。
Since typical clinical presentation of swine influenza infection in humans resembles seasonal influenza and other acute upper respiratory tract infections, most of the cases have been detected by chance through seasonal influenza surveillance. Mild or asymptomatic cases may have escaped from recognition; therefore the true extent of this disease among humans is unknown.	由于人间甲型H1N1流感感染典型的临床表现类似季节性流感及其它急性上呼吸道感染，所以多数病例是通过对季节性流感的监测偶然发现的。轻度或无症状的病例可能未被识别，因此该病在人间的真正规模尚不可知。
Where have human cases occurred? 什么地方发生了人患病例？
Since the implementation of IHR(2005)1 in 2007, WHO has been notified of swine influenza cases from the United States and Spain.	自2007年实施《国际卫生条例（2005）》以来，美国和西班牙向世卫组织通报了猪流感病例。
How do people become infected? 人如何染病
Humans usually contract swine influenza from infected pigs, however, some cases lack contact history with pigs or environments where pigs have been located. Human‐to‐human transmission has occurred in some instances but was limited to close contacts and closed groups of people.	人患甲型H1N1流感通常来自被感染的猪，但有些人患病例没有与猪或猪所在环境接触的历史。在有些情况中发生了人际传播，但仅限于密切接触者和封闭环境中的人群。
Which countries have been affected by outbreaks in pigs? 哪些国家受到猪群疫情的影响？
Swine influenza is not notifiable to international animal health authorities (OIE, www.oie.int), therefore its international distribution in animals is not well known. The disease is considered endemic in the United States. Outbreaks in pigs are also known to have occurred in North America, South America, Europe (including the UK, Sweden, and Italy), Africa (Kenya), and in parts of eastern Asia including China and Japan.	未要求向国际动物卫生主管当局（国际兽疫局，www.oie.int）通报猪流感，因此对其在动物中的国际分布情况缺乏了解。据认为，该病在美国流行。已知在北美、南美、欧洲（包括英国、瑞典和意大利）、非洲（肯尼亚）以及东亚部分地区（包括中国和日本）曾在猪群中发生过疫情。
What about the pandemic risk? 是否有发生大流行的危险？
It is likely that most people, especially those who do not have regular contact with pigs, do not have immunity to swine influenza viruses that can prevent the virus infection. If a swine virus establishes efficient human‐to human transmission, it can cause an influenza pandemic. The impact of a pandemic caused by such a virus is difficult to predict: it depends on virulence of the virus, existing immunity among people, cross protection by antibodies acquired from seasonal influenza infection and host factors.	很可能多数人，尤其是不经常接触猪的人，对甲型H1N1流感病毒没有可预防病毒感染的免疫力。如果一种猪病毒形成有效的人际传播，它可引起流感大流行。很难预测由这种病毒引起的大流行的影响：这取决于病毒的毒力、人群中现有的免疫力、从季节性流感感染所获得抗体的交叉保护作用以及宿主因素。
Is there a human vaccine to protect against swine influenza? 有没有防范甲型H1N1流感的人用疫苗？
There are no vaccines that contain the current swine influenza virus causing illness in humans. It is not known whether current human seasonal influenza vaccines can provide any protection. Influenza viruses change very quickly. It is important to develop a vaccine against the currently circulating virus strain for it to provide maximum protection to the vaccinated people. This is why WHO needs access to as many viruses as possible in order to select the most appropriate candidate vaccine virus.	没有疫苗包含当前引起人类疾病的甲型H1N1流感病毒。目前的人类季节性流感疫苗是否能提供任何保护，尚不可知。流感病毒变化很快。必须研制一种疫苗来应对当前传播的病毒毒株，为接受接种的人提供最大程度的保护。这就是为什么世卫组织需要获得尽可能多的病毒，以便选定最适当的候选疫苗病毒。
What medicines are available for treatment? 可用于治疗的药物有哪些？
There are two classes of such medicines, 1) adamantanes (amantadine and remantadine), and 2) inhibitors of influenza neuraminidase (oseltamivir and zanamivir).		这种药物有两类：1）金刚烷（金刚烷胺和金刚乙胺）；2）流感病毒神经氨酸酶抑制剂（奥司他韦和扎那米韦）。
Most of the previously reported swine influenza cases recovered fully from the disease without requiring medical attention and without antiviral medicines.		以前报告的多数甲型H1N1流感病例都能完全康复，不需要看医生，也不需要服用抗病毒药物。
Some influenza viruses develop resistance to the antiviral medicines, limiting the effectiveness of treatment. The viruses obtained from the recent human cases with swine influenza in the United States are sensitive to oselatmivir and zanamivir but resistant to amantadine and remantadine.		这些流感病毒对抗病毒药物形成抗药性，从而限制了药物预防和治疗的有效性。从美国最近的甲型H1N1流感人患病例获得的病毒对奥司他韦和扎那米韦是敏感的，但对金刚烷胺和金刚乙胺具有抗药性。
Information is insufficient to make recommendations on the use of the antivirals in treatment of swine influenza virus infection. Clinicians should make decisions based on the clinical and epidemiological assessment and harms and benefits of the treatment of the patient2. For the ongoing outbreak of the swine influenza infection in the United States and Mexico, national and local authorities are recommending use oseltamivir or zanamivir for treatment of the disease based on the virus’s susceptibility profile.		缺乏足够的信息，所以不能就如何使用抗病毒药物预防和治疗甲型H1N1流感病毒感染提出建议。临床医生需要以临床和流行病学评估以及对病人进行药物预防/治疗的危害和效益为基础作出决定。针对美国和墨西哥正在发生的甲型H1N1流感感染疫情，国家和地方当局建议根据病毒的易感性情况使用奥司他韦或扎那米韦进行治疗和预防。
What should I do if I am in regular contact with pigs? 如果我经常与猪接触，应该采取什么措施？
Even though there is no clear indication that the current human cases with swine influenza infection are related to recent or ongoing influenza‐like disease events in pigs, it would be advisable to minimize contact with sick pigs and report such animals to relevant animal health authorities.		即使尚无任何明显的迹象表明目前的甲型H1N1流感感染人患病例与最近或正在发生的猪群流感样疾病事件有关，最好也应尽量减少与病猪接触，并将病猪情况上报有关动物卫生部门。
Most people are infected through prolonged, close contact with infected pigs. Good hygiene practices are essential in all contact with animals and are especially important during slaughter and post‐slaughter handling to prevent exposure to disease agents. Sick animals or animals that died from disease should not be undergoing slaughtering procedures. Follow further advice from relevant national authorities.		长时间与受感染猪群密切接触，多数人会感染疾病。良好卫生习惯在与动物接触中至关重要，尤其是在屠宰和屠宰后处理过程中，必须避免接触疾病媒介。不应对患病动物或病死的动物实施屠宰程序。遵守国家有关当局作出的进一步规定。
How can I protect myself from getting swine influenza from infected people? 怎样做才不会从受感染者身上传染猪流感？
In the past, human infection with swine influenza was generally mild but is known to have caused severe illness such as pneumonia. For the current outbreaks in the United States and Mexico however, the clinical pictures have been different. None of the confirmed cases in the United States have had the severe form of the disease and the patients recovered from illness without requiring medical care. In Mexico, some patients reportedly had the severe form of the disease.		过去的人类感染甲型H1N1流感一般症状较轻，但已知现已造成了肺炎这类严重的疾病。然而，目前美国和墨西哥的疫情却有着不同的临床症状。在美国，无一例确诊病例为严重的疾病，患者无需治疗即可康复。但据报道，墨西哥一些患者的疾病症状较严重。
To protect yourself, practice general preventive measures for influenza:		做好自我保护工作，可采取一般流感预防措施：
l Avoid close contact with people who appear unwell and who have fever and cough.		l 避免与看起来身体不适和有发烧和咳嗽症状的人密切接触。
l Wash your hands with soap and water frequently and thoroughly.		l 经常和彻底地用肥皂和水清洗双手。
l Practice good health habits including adequate sleep, eating nutritious food, and keeping physically active.		l 保持良好卫生习惯，包括睡眠充足、营养膳食和坚持锻炼。
If there is an ill person at home:		如果家里有病人的话：
l Try to provide the ill person a separate section in the house. If this is not possible, keep the patient at least 1 meter in distance from others.		l 设法在家中为病人单独辟出一块空间。如果这样做不可行，让病人与其它人至少保持一米远的距离。
l Cover mouth and nose when caring for the ill person. Masks can be bought commercially or made using the readily available materials as long as they are disposed of or cleaned properly.		l 护理病人时掩住口鼻。可从店里购买口罩，或者使用现成材料自己制作，只要可加以适当清洗。
l Wash your hands with soap and water thoroughly after each contact with the ill person.		l 每次与病人接触之后，彻底用肥皂和水清洗双手。
l Try to improve the air flow in the area where the ill person stays. Use doors and windows to take advantage of breezes.		l 设法改善病人居所的空气流通状况。利用门窗进来一点微风。
l Keep the environment clean with readily available household cleaning agents.		l 使用现成的家庭清洗剂保持环境清洁卫生。
If you are living in a country where swine influenza has caused disease in humans, follow additional advice from national and local health authorities.		如果在你生活的国家中甲型H1N1流感已造成人类疾病，请遵循国家和地方卫生当局发布的补充建议。
What should I do if I think I have swine influenza?如果认为自己已患上甲型H1N1流感，应该怎么办？
If you feel unwell, have high fever, cough and/or sore throat:		如果你感觉不适，发高烧，咳嗽和（或）喉咙痛：
l Stay at home and keep away from work, school or crowds as much as possible.		l 尽可能呆在家中，不要上班、上学或去人多的地方。
l Rest and take plenty of fluids.		l 休息并大量饮水。
l Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose of the used tissues properly.		l 咳嗽和打喷嚏时用一次性纸巾掩住口鼻，并适当处理用过的纸巾。
l Wash your hands with soap and water frequently and thoroughly, especially after coughing or sneezing.		l 经常和彻底地用肥皂和水清洗双手，特别是在咳嗽或打喷嚏之后。
l Inform family and friends about your illness and seek help for household chores that require contact with other people such as shopping.		l 将你的病情告诉家人和朋友，并寻求他人帮助来处理需要与其它人接触的家务活，比如采购东西。
If you need medical attention:		如果你需要求医：
l Contact your doctor or healthcare provider before travelling to see them and report your symptoms. Explain why you think you have swine influenza (for example, if you have recently travelled to a country where there is a swine influenza outbreak in humans). Follow the advice given to you for care.		l 去看医生或到保健机构看病前先与之进行联系，并报告你目前的症状。说明为什么你认为自己患上甲型H1N1流感（例如，你是否最近去过发生人间猪流感疫情的国家）。遵循医生给你的治疗意见。
l If it is not possible to contact your healthcare provider in advance, communicate your suspicion of having swine influenza immediately upon arrival at the healthcare facility.		l 如果无法预先与所在地保健机构取得联系，抵达保健机构后立即说明你怀疑自己患有甲型H1N1流感。
l Take care to cover your nose and mouth during travel.		l 外出期间注意掩盖口鼻。